Psycho-oncology: review and update.

The field of psycho-oncology is moving forward rapidly, especially for a relatively new field. Cancer patients and survivors are willing to discuss their needs and interests relating to diagnosis and treatment. There are guidelines and algorithms for determining levels of distress in cancer patients in both inpatient and outpatient settings. The pharmacologic treatment of distress, particularly depression, has vastly improved. Randomized controlled trials are becoming available for patients in order to determine the efficacy of psychotropic drugs. Numerous interventions are available to help cancer patients move forward with their lives. Some of these interventions began in the 1980s and have progressed to the use of complementary and alternative medicine techniques as coping strategies for cancer. With the rapid expansion of the Internet, cancer survivors' thirst for information also has grown. Many resources are available to help guide cancer patients through the maze of the diagnosis and treatment of cancer.

Relationships among compulsive hoarding, trauma, and attention-deficit/hyperactivity disorder.

The current study investigated aspects of post-traumatic stress disorder and attention deficit/ hyperactivity disorder (ADHD) among hoarders. Compared to a sample of 36 controls, hoarders (n=26) reported a significantly greater number of different types of trauma, more frequent traumatic experiences, more symptoms of inattention, hyperactivity, and greater comfort derived from possessions. These findings are consistent with previous reports of extensive comorbidity associated with hoarding behaviors, and may reflect the potential usefulness of assessing PTSD and ADHD symptoms at the outset of hoarding treatments, as well as considering alternative pharmacological interventions.

Actual and perceived memory deficits in individuals with compulsive hoarding.

Memory problems have been hypothesized to underlie compulsive hoarding behavior [Frost and Hartl, 1996: Behav Res Ther 34:341-350]. This study examined memory performance, memory confidence, and memory beliefs in 22 individuals with severe hoarding symptoms and 24 matched normal control subjects. Participants were administered two measures of learning and memory that required strategic planning and organization for successful performance: the Rey-Osterrieth Complex Figure Test (RCFT) and California Verbal Learning Test (CVLT). Self-reports of memory confidence, perceived consequences of forgetting, importance of remembering, and need to keep possessions in sight also were assessed. In comparison to controls, participants with compulsive hoarding recalled less information on delayed recall of the RCFT and CVLT and used less effective organizational strategies on the RCFT but not the CVLT. Hoarders also reported significantly less confidence in their memory, more catastrophic assessments of the consequences of forgetting, and a stronger desire to keep possessions in sight. Results provide initial evidence of learning and memory impairment and poor memory confidence in subjects with compulsive hoarding.

Cognitive and motor function after administration of hydrocodone bitartrate plus ibuprofen, ibuprofen alone, or placebo in healthy subjects with exercise-induced muscle damage: a randomized, repeated-dose, placebo-controlled study.

RATIONALE: Medications combining hydrocodone bitartrate and non-steroidal anti-inflammatory agents appear more beneficial than anti-inflammatory medications alone in treating pain and inflammation from acute soft tissue trauma, but opiate side effects may include sedation and impaired cognitive and motor performance. OBJECTIVE: Performance on complex cognitive and motor tasks was evaluated in healthy subjects with exercise-induced muscle damage who were treated with a hydrocodone-ibuprofen combination, ibuprofen alone, or placebo. METHODS: This double-blind, randomized, placebo-controlled, repeated-dose clinical trial compared the effects of hydrocodone bitartrate (7.5 mg) plus ibuprofen (200 mg), ibuprofen alone, and placebo on cognitive and motor function in 72 healthy college men. Muscle damage in the quadriceps of each subject's dominant leg was induced by an eccentric exercise protocol. Subjects took the study medication four times daily (every 4-6 h) for 5 days. Forty minutes after medication ingestion at the same time each day, subjects underwent tests of attention/concentration, motor performance, and reaction time. Four trained assessors rotated among subjects so that none tested the same participant on more than three occasions. RESULTS: Repeated measures analyses of covariance revealed no between-group differences on a complex memory and cognition task or complex reaction time. Subjects using hydrocodone bitartrate plus ibuprofen performed significantly less well on a simple tracking task and made significantly more errors on a simple reaction-time task than the other two groups. These deficits were found to be highly transitory and not related to confusion or fatigue. CONCLUSION: Hydrocodone plus ibuprofen was not associated with deterioration in complex cognition but was related to very transitory decrements in tasks involving simple hand-eye coordination.